The inspection took place on 15 and 16 June 2015 and was announced.
Guild Care Domiciliary Care provides support and personal care to people in their own homes. It covers the geographical area along the West Sussex coast from Littlehampton up to Southwick. People receiving home care support have a range of needs: physical and/or mental health issues, medical conditions, older people and people living with dementia.
The service has a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People’s safety was compromised in some areas. Risks to people were not managed safely. People’s risks had not been assessed adequately to keep them from harm. There was conflicting information in people’s care records as to whether they needed prompting to take their medicines, needed medicines to be administered or could take their medicines independently. People’s medicines were not managed safely. People said they felt safe and staff knew what action to take if they suspected people were at risk of abuse. Staff had received training in safeguarding adults at risk. There were sufficient staff to meet people’s needs safely and the service followed safe recruitment practices.
Staff understanding of the Mental Capacity Act (MCA) 2005 and the requirements of this legislation was patchy. People’s capacity to make decisions had not been assessed or documented in their care records. Apart from a lack of dedicated training to staff on the MCA, staff had received all essential training. People spoke positively about the care and support they received. The provider had a comprehensive induction programme. Staff had regular supervisions and appraisals, however, some staff supervisions and appraisals were not up to date. The registered manager was taking steps to improve this. People generally had sufficient to eat and drink, but food and fluid monitoring charts did not always show the quantities that people had consumed on a daily basis. This put people at risk of malnourishment. People were supported by staff to have access to healthcare professionals when needed.
People spoke highly of the staff who supported them. Positive, caring relationships had been developed and people were treated with dignity and respect. People were encouraged to express their views and to be involved in decisions about their care.
The provider had made improvements to the punctuality of staff and call times to people’s homes were monitored and audited. Care plans provided information to staff about people’s likes, dislikes and preferences. Daily records were completed by staff and kept on people’s home care files. Concerns and complaints were responded to and acted upon in a timely fashion, in line with the provider’s policy.
People had mixed views about the service; some comments were positive, others not so positive. People were asked what they thought about the quality of the service through a ‘home care survey’ which was last completed in July 2014. Staff were not formally asked for their views about the service. The provider undertook comprehensive audits, however, they had not identified that risk assessments were unsatisfactory. The audit had identified that there were gaps in Medication Administration Record (MAR) sheets and that, in some cases, staff supervisions and appraisals were overdue.
We found two of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have taken at the back of the full version of the report.